Introduction. Rheumatoid arthritis is a form of inflammatory joint disease; sometimes, patients need prolonged cycles of nonsteroidal anti-inflammatory drugs and/or glucocorticoids for symptomatology management in addition to traditional disease-modifying drugs and biologics. On some occasions, doses are increased without improvement of symptoms associated with side effects; this is why, on some occasions, patients seek other types of nonpharmacological therapies, such as alternative therapies. Objective. To establish the effectiveness of alternative therapies such as yoga and acupuncture in rheumatoid arthritis by measuring disease activity with the disease activity score 28. Methods. A systematic review of the literature and meta-analysis was performed; databases such as PubMed and Embase were used to find the best available evidence of randomized clinical trials from 2017 to 2021, two researchers independently screened and extracted the necessary data, and the methodological quality and the risk of bias were assessed through the Cochrane risk-of-bias tool. The articles that applied for meta-analysis were analyzed in Jamovi version 2.2 and EPIDATA version 3.1 software. Results. Eight studies were included for qualitative analysis of which seven were included in the meta-analysis, with 550 rheumatoid arthritis patients, predominantly female. The meta-analysis evidenced a significant effect of yoga and acupuncture interventions in decreasing DAS 28 in patients with rheumatoid arthritis (four RCTs; SMD −2.51 95% CI [−2.89, −2.14], , I² 25.9%); in the yoga subgroup analysis, there was also evidence of improvement in the evaluated outcome (three RCTs; SMD −0.51 95% CI [−0.71, −0.30], , I² 0%). Conclusion. It was demonstrated that the practice of yoga and acupuncture in patients with rheumatoid arthritis helped to decrease disease activity through the improvement of pain and joint inflammation; we recommend the implementation of this type of alternative intervention associated with conventional therapies for the management of patients diagnosed with rheumatoid arthritis.

中文翻译：

---

瑜伽和针灸治疗类风湿关节炎的有效性：系统评价和荟萃分析

介绍。类风湿性关节炎是一种炎症性关节疾病。有时，除了传统的疾病缓解药物和生物制剂外，患者还需要延长周期的非甾体抗炎药和/或糖皮质激素来进行症状管理。在某些情况下，增加剂量却没有改善与副作用相关的症状；这就是为什么在某些情况下，患者寻求其他类型的非药物疗法，例如替代疗法。客观的。通过用疾病活动评分测量疾病活动来确定瑜伽和针灸等替代疗法对类风湿性关节炎的有效性。 28.方法。对文献进行了系统回顾和荟萃分析；利用PubMed和Embase等数据库寻找2017年至2021年随机临床试验的最佳可用证据，两名研究人员独立筛选和提取必要的数据，并通过Cochrane风险评估评估方法学质量和偏倚风险- 偏差工具。申请荟萃分析的文章在Jamovi 2.2版和EPIDATA 3.1版软件中进行分析。结果。纳入了 8 项研究进行定性分析，其中 7 项研究纳入荟萃分析，涉及 550 名类风湿性关节炎患者，其中主要是女性。荟萃分析证明瑜伽和针灸干预对降低类风湿关节炎患者的 DAS 28 有显着效果（四项随机对照试验；SMD -2.51 95% CI [-2.89，-2.14]，, I ² 25.9%); 在瑜伽亚组分析中，也有证据表明评估结果有所改善（三项随机对照试验；SMD -0.51 95% CI [-0.71，-0.30]，, I ² 0%)。结论。研究表明，类风湿性关节炎患者练习瑜伽和针灸有助于通过改善疼痛和关节炎症来减少疾病活动性；我们建议对诊断为类风湿性关节炎的患者实施与常规疗法相关的此类替代干预措施。